Regression and Countertransference in the Treatment of a Borderline Patient
THE CASE PRESENTED in this paper demonstrates a borderline personality disorder that falls near the psychotic boundary on the continuum of psychopathological states. While there has been some debate about what constitutes a valid diagnosis of borderline personality disorder, the psychoanalytic treatment of patients whose character structures place them near the psychotic end of the continuum of psychopathological states has become increasingly accepted in North America during the past 15 to 20 years.! Before this acceptance of greater flexibility at the edges of the borderline definition, many patients were relegated to the category of untreatablevictims of a rigid adherence to diagnostic labels in selecting methodologies of treatment. I believe this greater flexibility has resulted from the synergistic contributions of three lines of research (although 1would not venture to rate the relative influences of the three). I refer to child analysis, longitudinal studies of mother-child interactions, and the persevering efforts of those few analysts who disagreed with Freud's stand that people who suffer from the so-called narcissistic neuroses are incapable of developing therapeutically useful transferences.